toddlers, age 2-3

Question 1

neuroblastoma

Answer 1

mass at adrenal medulla (kidneys)
CROSSES abdomin midline
painful abdominal mass, firm, irregular
1/2 present with metatastic disease
ultrasound, refer to nephrologist 

s/s; horner’s syndome, perioribital ecchymosis (raccoon eyes)

Question 2

wilm’s tumor (nephroblastoma)

Answer 2

DOES NOT CROSS ABDOMIN MIDLINE
1/4 have HTN
higher in black female children, 2-3 yo peak
most common renal malignancy in children

ultrasound

Question 3

epiglotottis

Answer 3

hot potato voice, won’t eat or drink
sitting posture with hyperextended neck and open mouth
due to H.influenzae, staph aureus, strep.

REPORTABLE disease, call 911
prophylaxis rifampin for close contacts

Question 4

osteomyelitis

Answer 4

infection of the bone/joint
limping
may effect growth plate, refer to hospital

Question 5

orbital cellulitis

Answer 5

pain with eye movement, fever, buldging eyes
ethmoid sinuisitis, complication of aim, dental infection, rhinosinuisitis
abnormal extraoculur eye mvmt (EOM)
ED for CT or MRI

Question 6

preseptal cellulitis (perorbital cellulitis)

Answer 6

eye movement NO pain, just pain of red woolen eyelids
EOM normal
refer to ed

Question 7

most common cancer/tumor in children

Answer 7

cancer: acute lymphocytic leukemia (ALL) and acute myelogenous leukemia (AML)

wilm’s tumor

Question 8

2 years old

Answer 8

stacks six tubes
straight line ( can copy)
2-3 word sentences
stairs ( using same foot)

Question 9

3 years old

Answer 9

draws circle
9 cubes
throw a ball over head
3 numbers, 3 colors 
"magical thinking"- imaginary friend 
"oepidal stage by freud (phallic), child expresses desire to marry opposite sex. 

does not like to share toys
“imgination”

Question 10

5 years old

Answer 10

square

identify and draw 4 body partys

Question 11

6- 7

Answer 11

triangle (6)
diamond (7)
rides a bicycle

Question 12

autism

Answer 12

can appear 18 months, usually 2-6 yo
5 behaviors;
does not point/wave/grasp by 1 yo
no babbling or cooing by 1 year old. does not say single words by 16 mos
does not say 2 word phrase by 2 yo
loss of language or social skills by 2 yo
does not gesture at 1-2 yo (wave, point, grasp)

Question 13

wilms tumor

Answer 13

congenital tumor of the kidneys
does NOT cross midline
more common in black female girls

Question 14

pt hyperextended neck and open mouth breathing

Answer 14

epiglottotis

Question 15

rolls both directions and plays peek abo

Answer 15

9 mos

Question 16

speech of 2 vs 3 yo

Answer 16

2- understood by family members

3- understood by strangers

Question 17

what stage 3-6yo when child wants to marry the parent of the opposite sex

Answer 17

oedipal stage